Severe Pain Between the Second and Third Ribs: Causes and Treatments - Pulmonology

More Info

---

Severe pain between the second and third ribs can be quite distressing, especially after an incident that involved pressure on the chest, such as leaning over while fishing. Given your symptoms and the context of your injury, there are several potential causes for the pain you are experiencing.


Possible Causes
1. Costochondritis: This is an inflammation of the cartilage that connects a rib to the sternum. It can cause localized pain that worsens with movement, deep breathing, or coughing. Given that you have been coughing for two weeks, this could have exacerbated any underlying irritation in the rib area.

2. Rib Fracture or Contusion: Although you mentioned that you did not feel any immediate pain after the incident, it is possible to have sustained a minor rib fracture or contusion that may not have been immediately apparent. Rib fractures can cause sharp pain, especially with movement or deep breaths.

3. Intercostal Muscle Strain: The intercostal muscles are located between the ribs and can be strained during activities that involve twisting or heavy lifting. If you were in an awkward position while fishing, it’s possible that you strained these muscles, leading to pain that is exacerbated by coughing or deep breathing.

4. Pleurisy: This is an inflammation of the pleura, the membrane surrounding the lungs, which can cause sharp chest pain that worsens with breathing or coughing. This is less likely unless you have other symptoms like fever or difficulty breathing.

5. Nerve Irritation: Sometimes, nerve irritation in the thoracic region can cause pain that feels localized between the ribs. This can happen due to muscle tension or inflammation.


Recommended Treatments
1. Rest: Avoid activities that exacerbate the pain, especially those that involve heavy lifting or twisting motions.

2. Ice Therapy: Applying ice to the affected area for 15-20 minutes several times a day can help reduce inflammation and numb the pain.

3. Over-the-Counter Pain Relief: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin) or naproxen (Aleve) can help alleviate pain and reduce inflammation. Always follow the recommended dosage and consult with a healthcare provider if you have any underlying health conditions.

4. Heat Therapy: After the initial inflammation has decreased (usually after 48 hours), applying heat can help relax tight muscles and improve blood flow to the area.

5. Physical Therapy: If the pain persists, a physical therapist can provide exercises to strengthen the muscles around the rib cage and improve flexibility, which may help alleviate pain.

6. Medical Evaluation: If the pain does not improve with home treatment, or if you experience additional symptoms such as difficulty breathing, fever, or worsening pain, it is crucial to seek medical attention. A healthcare provider may recommend imaging studies, such as an X-ray or MRI, to rule out fractures or other underlying issues.


Conclusion
In summary, the pain you are experiencing between the second and third ribs could be due to a variety of causes, including costochondritis, rib injury, muscle strain, or nerve irritation. It is essential to monitor your symptoms closely and seek medical attention if they worsen or do not improve with conservative treatment. Remember to take care of yourself and allow your body time to heal.